The progression of cancer involves a critical step in which malignant cells escape from control by the immune system. Antineoplastic agents are particularly efficient when they succeed in restoring such control (immunosurveillance) or at least establish an equilibrium state that slows down disease progression. This is true not only for immunotherapies, such as immune checkpoint inhibitors (ICIs), but also for conventional chemotherapy, targeted anticancer agents, and radiation therapy. Thus, therapeutics that stress and kill cancer cells while provoking a tumor-targeting immune response, referred to as immunogenic cell death, are particularly useful in combination with ICIs. Modern oncology regimens are increasingly using such combinations, which are referred to as chemoimmunotherapy, as well as combinations of multiple ICIs. However, the latter are generally associated with severe side effects compared with single-agent ICIs. Of note, the success of these combinatorial strategies against locally advanced or metastatic cancers is now spurring successful attempts to move them past the postoperative (adjuvant) setting to the preoperative (neoadjuvant) setting, even for patients with operable cancers. Here, the authors critically discuss the importance of immunosurveillance in modern clinical cancer management.

中文翻译：

---

临床癌症管理中的免疫监测


癌症的进展涉及一个关键步骤，在这个步骤中，恶性细胞会逃脱免疫系统的控制。当抗肿瘤药物成功恢复这种控制（免疫监视）或至少建立减缓疾病进展的平衡状态时，它们特别有效。这不仅适用于免疫疗法，例如免疫检查点抑制剂 （ICI），也适用于常规化疗、靶向抗癌药物和放射疗法。因此，在引发肿瘤靶向免疫反应（称为免疫原性细胞死亡）的同时对癌细胞施加压力和杀死的疗法与 ICI 联合使用特别有用。现代肿瘤学方案越来越多地使用这种组合，称为化学免疫疗法，以及多种 ICI 的组合。然而，与单药 ICI 相比，后者通常与严重的副作用有关。值得注意的是，这些针对局部晚期或转移性癌症的组合策略的成功现在正在刺激它们成功尝试将它们从术后（辅助）设置转移到术前（新辅助）设置，即使对于可手术的癌症患者也是如此。在这里，作者批判性地讨论了免疫监测在现代临床癌症管理中的重要性。